| Summary: | Endodontic treatment requires a thorough knowledge of the anatomy of the teeth and their surrounding structures. Root canals may be left without treatment during endodontic therapy if the dentist doesn't know the anatomic variations for each tooth. Usually, the mandibular first molars would have two roots with three canals (mesiobuccal, distal and mesiolingual) but in few of the teeth, the number of canals, and the roots will vary. An additional lingual root otherwise referred to as a mandibular first molar Radix Entomolaris and an extra Buccal root, also called a Radix Paramolaris with two distal roots is an exciting example of anatomic variation. This paper expounds upon the case report of a mandibular first molar with three roots and four canals [Radix Entomolaris (RE)]. A 12-year-old male patient, was diagnosed with Radix entomolaris on radiographic examination and treated in the Department of Conservative Dentistry and Endodontics. Mesiobuccal and mesiolingual and the radix canals were enlarged up to F2 ProTaper files. As the distal root was curved, it was enlarged only up to F2 ProTaper file. The root canals were medicated with a calcium hydroxide dressing, and the access cavity was temporarily sealed with a temporary restoration. One week later the root canals were obturated. Initially, the corresponding sized gutta-percha master cones for the four canals were selected. The selected gutta-percha cone was coated with AH Plus sealer and placed in the canal. The System B Heat Source was adopted to remove the coronal portion of the gutta-percha cone. The Obtura II system was used for the back-filling with the application of gutta-percha in small increments. The access cavity was sealed with miracle mix (silver alloy admix GIC), and the root canal filling was evaluated radiographically.
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